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• Clinical Article •
MR Imaging assessment of correlations between Pfirrmann’s grading system and lumbar disc bulge and lumbar disc protrution in young patients
ZHENG Zuo-feng  LI You-wei  ZHANG Dong-po  MAO Lei 

DOI:10.12015/issn.1674-8034.2016.03.08.


[Abstract] Objective: To find the MRI characteristics of the lumbar intervertebral disc degeneration in patients less than 30 years old with low back pain, and try to evaluate the correlations between Pfirrmann’s grading scale and intervertebral disc bugle and intervertebral disc protrution.Material and Methods: It is a cross-sectional and observational study. A total of 83 patients with low back pain performed lumbar MRI examination. All patients were less than 30 years old, of whom 50 were men and 33 were women, with mean age 25. All MR imaging were evaluated by two radiologists in the following aspects: signal intensity and morphology of the intervertebral discs, annular tear, intervertebral disc bulge, intervertebral disc protution, Modic changes and the Schmorl’s nodes. The intervertebral discs degeneration were evaluated through Pfirrmann’s classification system. The association between these different aspects were analyzed by Pearson multiple correlation.Results: A total of 415 intervertebral discs were examined, of which grade Ⅰ—Ⅱ discs were 322 (77.6%), grade Ⅲ 56 (13.5%), grade Ⅳ 33 (7.9%) and grade Ⅴ 4 (1%). One hundred and three intervertebral discs were found with disc bulge and disc protrution, most of which were at disc L4—5 and L5—S1 level and were common in grade Ⅲ and grade Ⅳ degenerations. Seventeen patients were found with HIZ, and were all at disc L4—5 and L5—S1 level. Three patients were found with modic change. The statistic results show that grade Ⅲ degeneration were correlated well with disc bulge (r=0.972, P=0.006), but not with disc protrution (r=0.639, P=0.245) and the grade Ⅳ disc degeneration were correlated with disc protrution (r=0.999, P=0.000) and HIZ (r=0.919, P=0.028), but not with disc bulge (r=0.769, P=0.128). HIZ were correlated well with both disc bulge (r=0.919, P=0.027) and disc protrution (r=0.935, P=0.020).Conclusions: MRI is a good imaging modality for detecting the pathology character of disc degeneration in early stage. Grade and grade degenerations have close relationship with intervertebral disc bulge and protrution. It may have great clinical value to detect early changes of intervertebral disc degeneration in young patients.
[Keywords] Intervertebral disk displacement；Magnetic resonance imaging；Young adult

ZHENG Zuo-feng Department of Radiology, Beijing Chuiyangliu Hospital, Beijing 100022, China

LI You-wei* Department of Radiology, Beijing Chuiyangliu Hospital, Beijing 100022, China

ZHANG Dong-po Department of Radiology, Beijing Chuiyangliu Hospital, Beijing 100022, China

MAO Lei Department of Radiology, Beijing Chuiyangliu Hospital, Beijing 100022, China

*Correspondence to: Li YW, E-mail: lywhot@sohu.com

Conflicts of interest   None.

Received  2016-01-03
Accepted  2016-02-15
DOI: 10.12015/issn.1674-8034.2016.03.08
DOI:10.12015/issn.1674-8034.2016.03.08.

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